The research found that laws, policies and police practice severely impact the implementation of China’s HIV response. And the use of condoms as evidence of sex work, and police crackdowns on the sex sector, contradict government health policy and put sex workers at risk.

Asia Catalyst worked with four community-based organisations in China plus the UNFPA China office to conduct the research. Sex workers actively participated in defining the research topic, planning the research and interviewing over 500 female, male and transgender sex workers in three Chinese cities.

The report recognises the significant and often progressive efforts the Chinese government has made in HIV prevention and treatment. The government pays for over 98% of all HIV response costs, for example, and focus on key populations. Condoms play a central role in China’s HIV strategy. The government allocates budget every year for free distribution of condoms to key populations including sex workers. In many provinces entertainment venues are required to display condoms publicly.

On the other hand, sex work is illegal in China. Sex workers are regularly interrogated, fined, and detained by police. Police specifically target condoms, and they use possession of condoms as the main evidence of sex work. The Public Security Bureau – China’s domestic law enforcement department – is required to crack down on sex work. Their main tactic is the seizure of condoms.

The research found that sex workers who had experienced police interrogation reported carrying and consistently using condoms less often than those who had not been interrogated. Sex workers also reported that dealing with the police was a daily reality. Half of the respondents reported having been interrogated, and over one third had experienced condom searches by police. Of those interrogated in the last year, one fifth said they would now use condoms less often.

Sex workers in the study revealed that police actions always targeted condoms, even when the police activity was not related directly to a sexual transaction. Sex workers reported police looking for condoms in wastebaskets, beds and quilts, handbags and even removing the trousers of a client. If police found condoms, then they took the sex worker to the police station for further action. Condoms were the deciding factor.

According to A-Hong, a male sex worker interviewed in the research, this police behavior has a direct impact:

“The boss doesn’t dare to put condoms out in the open and hides them all away. It’s a real hassle for us to find them. Every three to five days he distributes them to us a few at a time.”

The research also found that police crackdowns on the sex sector have caused policy confusion. In the past, managers of entertainment venues allowed health workers access for HIV prevention work with sex workers. However after the “vice raids” began, managers of these venues told health staff that no target groups worked there, and they were afraid to put condoms out. The research found law enforcement actions decreased the overall availability of condoms in sex work venues, despite health department requirements that condoms be on display.

The report makes a number of recommendations, including:

An immediate stop to the use of condoms as evidence of sex work

Health and security departments should set up working groups to coordinate and solve issues that prevent sex workers from accessing SRH and HIV health services

Police officers should receive training on the human rights of sex workers and the importance of condoms in preventing HIV

Sex workers should have a process for filing complaints of misconduct by police

HIV programs should be designed and implemented in consultation with sex workers.

“This not only an issue in China, it is a common practice in most of the countries of Asia and the Pacific. Even in countries that have a policy not to use condoms as evidence, low ranking police officers continue to do so and arrest sex workers. When they file the cases, however, they do not say that condoms were used as evidence. So each and every country needs to put an end to the practice of using condoms as evidence of sex work.”

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